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- Title
Users' Guides to the Medical Literature: XXV. Evidence-based medicine: principles for applying the Users' Guides to patient care. Evidence-Based Medicine Working Group.
- Authors
Guyatt GH; Haynes RB; Jaeschke RZ; Cook DJ; Green L; Naylor CD; Wilson MC; Richardson WC; Evidence-Based Medicine Working Group; Guyatt, G H; Haynes, R B; Jaeschke, R Z; Cook, D J; Green, L; Naylor, C D; Wilson, M C; Richardson, W S
- Abstract
This series provides clinicians with strategies and tools to interpret and integrate evidence from published research in their care of patients. The 2 key principles for applying all the articles in this series to patient care relate to the value-laden nature of clinical decisions and to the hierarchy of evidence postulated by evidence-based medicine. Clinicians need to be able to distinguish high from low quality in primary studies, systematic reviews, practice guidelines, and other integrative research focused on management recommendations. An evidence-based practitioner must also understand the patient's circumstances or predicament; identify knowledge gaps and frame questions to fill those gaps; conduct an efficient literature search; critically appraise the research evidence; and apply that evidence to patient care. However, treatment judgments often reflect clinician or societal values concerning whether intervention benefits are worth the cost. Many unanswered questions concerning how to elicit preferences and how to incorporate them in clinical encounters constitute an enormously challenging frontier for evidence-based medicine. Time limitation remains the biggest obstacle to evidence-based practice but clinicians should seek evidence from as high in the appropriate hierarchy of evidence as possible, and every clinical decision should be geared toward the particular circumstances of the patient.
- Publication
JAMA: Journal of the American Medical Association, 2000, Vol 284, Issue 10, p1290
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.284.10.1290